RT Journal Article
SR Electronic
T1 A pilot study to assess the efficacy of breathlessness plans for patients with chronic obstructive pulmonary disease (COPD)
JF European Respiratory Journal
JO Eur Respir J
FD European Respiratory Society
SP PA3678
DO 10.1183/13993003.congress-2016.PA3678
VO 48
IS suppl 60
A1 Mary Qian
A1 Michelle Thompson
A1 Brian Le
A1 Louis Irving
A1 Natasha Smallwood
YR 2016
UL http://erj.ersjournals.com/content/48/suppl_60/PA3678.abstract
AB Refractory breathlessness is common, and undertreated, in patients with advanced COPD. At times of dyspnoea crisis, patients and carers can be overwhelmed and may underutilise active dyspnoea management strategies, including opioids.Aim: To assess if written individualised Breathlessness Plans (BP) improve dyspnoea self-management.Methods: Eligible patients attending the Advanced Lung Disease Clinic at The Royal Melbourne Hospital were offered a written BP and dyspnoea education. Outcome data were measured at baseline and after 6 weeks.Results: Eighteen patients enrolled: 12 (67%) female, mean age 73 years. Mean lung function: FEV1 0.7L (35%), FVC 1.8L (73%) and DLco 32%. Median MMRC dyspnoea score 3.6. Fourteen patients (78%) used home oxygen and all had completed pulmonary rehabilitation prior to study enrolment. Mean number of hospital admissions in past 12 months: 3.Twelve patients (67%) used opioids for refractory dyspnoea, with no dose change in the 6 weeks prior to start of enrolment. Median opioid dose 27mg/24hours oral morphine equivalent (IQR 12-37mg).View this table:Results (mean±SD)A clinically significant improvement in dyspnoea was seen on the NRS, and in disease mastery on the CRQ.Conclusion: Preliminary results from this study suggest a written BP can improve dyspnoea and disease mastery, and has a role in the complex management of refractory dyspnoea.